Aortic Aneurysm Flashcards
What is an aortic aneurysm?
This is an abnormal dilatation of the aortic lumen; a true aneurysm involves all the layers of the wall. It is an aneurysm if 3cm and greater.
What are the causes of an aortic aneurysm?
Atheroma, trauma, connective tissue disorder, infection, inflammatory
What are risk factors for it?
Smoking, HTN, Male 5:1, increasing age
What is Marfan’s syndrome?
This disorder of connective tissue is inherited as an autosomal dominant trait and is caused by mutations in the fibrillin gene on chromosome 15. ). Weakening of the aortic media leads to aortic root dilatation, regurgitation and dissection. Can also causes aneurysm.
How is marfan’s managed?
Beta-blockers - reduces risk of rupture
Elective replacement of ascending aorta
How does Syphilis cause aortic aneurysms?
Causes aortitis that characteristically produces saccular aneurysms of the ascending aorta containing calcification
How do thoracic aortic aneurysms present?
Chest pain, aortic regurgitation, compressive symptoms such as stridor (trachea, bronchus) and hoarseness (recurrent laryngeal nerve), and superior vena cava syndrome. If they erode into adjacent structures, e.g. aorto-oesophageal fistula, massive bleeding occurs.
How is an AAA diagnosis established?
USS, MRI/CT to see anatomical relation to renal and visceral vessels
What is UK screening programme for AAA?
Single USS for all men at age65
What are signs and symptoms of AAA?
Intermittent or continuous pain( radiates to back, iliac fossa & groin), Expansile abdominal mass, Collapse; Shock
When is an AAA at high risk of rupture?
symptomatic, diameter >/= to 5.5cm or rapidly enlarging (>1cm/year)
How is AAA treated?
Open repair with a prosthetic (Dacron) graft or endovascular aneurysm repair (EVAR) via the femoral artery
How is a low risk AAA managed?
Abdominal US surveillance and optimise cardiovascular risk factors (e.g. stop smoking)
